How does it work?

Prostap SR injection contains the active ingredient leuprorelin acetate, which is a type of medicine known as a gonadorelin (LHRH) analogue. It acts on the pituitary gland in the brain.

The pituitary gland produces and stores various hormones, including the sex hormones, luteinising hormone (LH) and follicle-stimulating hormone (FSH). In men, LH released from the pituitary gland causes the testicles to produce testosterone. FSH and testosterone cause the production of sperm by the testicles. In women, FSH and LH cause the production of oestrogen by the ovaries and help control the menstrual cycle.

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The amount of LH and FSH released from the pituitary gland is controlled by another hormone, called gonaderelin (LHRH). Gonadorelin acts on LHRH receptors in the pituitary gland, causing the release of LH and FSH and hence the subsequent production of testosterone in men and oestrogen in women.

Leuprorelin acetate is a synthetic form of gonaderelin. It acts on the LHRH receptors in the pituitary gland in the same way as natural gonadorelin.

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Initially, leuprorelin causes an increase in the amount of FSH and LH released from the pituitary gland, with resulting increase in testosterone production in men and oestrogen production in women. However, chronic administration of leuprorelin desensitises the pituitary gland. This means that it produces less and less FSH and LH, which in turn stops the production of oestrogens in women and testosterone in men. As it reduces the levels of sex hormones, leuprorelin is used to treat disorders that are linked to levels of oestrogen or testosterone.

In men, the growth of some prostate cancers is stimulated by testosterone. Reducing the body's levels of testosterone therefore deprives the tumour of testosterone and causes it to shrink.

In women, endometriosis and uterine fibroids are treated with leuprorelin. Endometriosis is a condition where tissue resembling the womb or uterus lining (endometrium) grows in other sites in the body. The growth of this tissue is stimulated by oestrogen, so decreasing oestrogen levels with leuprorelin will stop the growth of this tissue, thereby relieving symptoms.

The effect of leuprorelin on endometrial tissue can also be used to thin the lining of the womb (endometrium) before endometrial surgery, such as endometrial ablation or resection.

The growth of fibroids in the uterus is also stimulated by oestrogen, so leuprorelin is used to decrease oestrogen levels and hence decrease the size of fibroids prior to surgery.

How is this treatment given?

Prostap SR injection is a long-acting injection that is adminstered under the skin (subcutaneously) or into a muscle (intramuscularly). The site that this injection is given into should be varied periodically.

The injection is given once a month to treat prostate cancer in men. As the leuprorelin may increase testosterone levels at first, it may cause an initial temporary tumour 'flare', with symptoms such as urinary obstruction and bone pain, before the cancer begins to shrink. Some men may be particularly prone to these symptoms. If this applies to you, your doctor will also treat you with another type of anti-cancer medicine, known as an anti-androgen (eg cyproterone acetate or flutamide) to prevent this. The anti-androgen will be started three days before your first Prostap SR injection and continued for two to three weeks.

Endometriosis is treated with an injection of Prostap SR once a month for six months, starting in the first five days of the menstrual cycle. (Day one is the first day of your period.)

Treatment to thin the womb lining is with a single injection of Prostap SR during days three to five of the menstrual cycle, five to six weeks before the surgery.

Fibroids are treated with an injection of Prostap SR every month, usually for three to four months but up to a maximum of six months.

As with the treatment of prostate cancer in men, administration of leuprorelin in women may cause a temporary increase in symptoms in the first few days after the injection, due to the initial rise in oestrogen levels. This improves as the oestrogen levels decrease.

Warning!

This medicine may cause dizziness and visual disturbances. You should make sure you are aware of your reactions to this medicine before driving or operating machinery.

This medicine should cause womens' menstrual periods to stop. If you are still experiencing menstrual bleeds despite treatment, you should consult your doctor.

Leuprorelin also inhibits ovulation in women, but it is not a reliable contraceptive. Women should use non-hormonal methods of contraception such as condoms to prevent pregnancy during treatment, as this medicine may be harmful to a developing baby. If you miss a dose of this medicine, breakthrough bleeding or ovulation may occur. Since this increases the risk of getting pregnant, you should continue using contraception even if you miss a dose. Consult your doctor if you think you could be pregnant.

In women treated for uterine fibroids this medicine can cause severe bleeding or pain when the fibroids break down. Consult your doctor if you experience severe or abnormal bleeding or pain.

Your liver function should be monitored while you are having treatment with this medicine.

People who have been having long-term treatment with corticosteroids (eg hydrocortisone, prednisolone) or antiepileptic medicines.

People with a history of heavy drinking or smoking.

Men considered by their doctor to be at risk of an initial worsening of their tumour symptoms (tumour flare) when starting treatment.

Men whose cancer has spread to the spine.

Men with urinary obstruction.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

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This medicine should not be used during pregnancy as it may be harmful to a developing baby. Women should use non-hormonal methods of contraception such as condoms to prevent pregnancy during treatment. Seek further medical advice from your doctor.

This medicine must not be used in women who are breastfeeding. Seek further advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

General side effects:

Reactions at the injection site, for example pain, redness, swelling or development of a hard lump, abscess or ulcer.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

This medicine is not known to affect other medicines. However, it is important to tell your doctor if you are taking any other medicines before you have your first injection, so they can check that the combination is safe and apporpriate to use. You should also get advice from your pharmacist before taking any other medicines while you are having treatment with this one.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.

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